The Utility of Decision Support, Clinical Guidelines, and Financial Incentives as Tools to Achieve Improved Clinical Performance.
Whether one seeks to reduce inappropriate utilization of resources, improve diagnostic accuracy, increase utilization of effective therapies, or reduce the incidence of complications, the key to change is physician involvement in change.
Unfortunately, a simple approach to the problem of inducing change in physician behavior is not available.
Comprehensive clinical guidelines : There is a generally accepted view that expert, best-practice guidelines will improve clinical performance.
However, there may be a bias to report positive results and a lack of careful analysis of guideline usage in routine practice in a « postmarketing » study akin to that seen in the pharmaceutical industry.
Financial incentives : Systems that allow the reliable assessment of quality of outcomes, efficiency of resource utilization, and accurate assessment of the risks associated with the care of given patient populations must be widely available before deciding whether an incentive-based system for providing the full range of medical care is feasible.
Decision support : Decision support focuses on providing information, ideally at the « point of service » and in the context of a particular clinical situation.
Rules are self-imposed by physicians and are therefore much more likely to be adopted. (...)
Mots-clés Pascal : Méthodologie, Validité, Epidémiologie, Méthode étude, Recommandation, Diagnostic, Médecin, Pratique professionnelle, Traitement, Aide décision
Mots-clés Pascal anglais : Methodology, Validity, Epidemiology, Investigation method, Recommendation, Diagnosis, Physician, Professional practice, Treatment, Decision aid
Notice produite par :
ORS Auvergne - Observatoire Régional de la Santé d'Auvergne
Code Inist : 002B30A11. Création : 31/05/1999.